Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia; Leiden University, Department of Developmental and Educational Psychology; Erasmus University Rotterdam, Erasmus School of Social and Behavioral Sciences.
Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.
J Affect Disord. 2022 Sep 1;312:268-274. doi: 10.1016/j.jad.2022.06.056. Epub 2022 Jun 26.
Structural brain alterations are observed in major depressive disorder (MDD). However, MDD is a highly heterogeneous disorder and specific clinical or biological characteristics of depression might relate to specific structural brain alterations. Clinical symptom subtypes of depression, as well as immuno-metabolic dysregulation associated with subtypes of depression, have been associated with brain alterations. Therefore, we examined if specific clinical and biological characteristics of depression show different brain alterations compared to overall depression.
Individuals with and without depressive and/or anxiety disorders from the Netherlands Study of Depression and Anxiety (NESDA) (328 participants from three timepoints leading to 541 observations) and the Mood Treatment with Antidepressants or Running (MOTAR) study (123 baseline participants) were included. Symptom profiles (atypical energy-related profile, melancholic profile and depression severity) and biological indices (inflammatory, metabolic syndrome, and immuno-metabolic indices) were created. The associations of the clinical and biological profiles with depression-related structural brain measures (anterior cingulate cortex [ACC], orbitofrontal cortex, insula, and nucleus accumbens) were examined dimensionally in both studies and meta-analysed.
Depression severity was negatively associated with rostral ACC thickness (B = -0.55, p = 0.03), and melancholic symptoms were negatively associated with caudal ACC thickness (B = -0.42, p = 0.03). The atypical energy-related symptom profile and immuno-metabolic indices did not show a consistent association with structural brain measures across studies.
Overall depression- and melancholic symptom severity showed a dose-response relationship with reduced ACC thickness. No associations between immuno-metabolic dysregulation and structural brain alterations were found, suggesting that although both are associated with depression, distinct mechanisms may be involved.
在重度抑郁症（MDD）中观察到结构性脑改变。然而，MDD 是一种高度异质的疾病，抑郁的特定临床或生物学特征可能与特定的结构性脑改变有关。抑郁的临床症状亚型，以及与抑郁亚型相关的免疫代谢失调，与大脑改变有关。因此，我们研究了抑郁的特定临床和生物学特征是否与整体抑郁相比表现出不同的大脑改变。
来自荷兰抑郁和焦虑研究（NESDA）（三个时间点的 328 名参与者，导致 541 个观察）和情绪治疗与抗抑郁药或跑步（MOTAR）研究（123 名基线参与者）的有和没有抑郁和/或焦虑障碍的个体被纳入研究。症状特征（非典型能量相关特征、忧郁特征和抑郁严重程度）和生物学指标（炎症、代谢综合征和免疫代谢指标）被创建。在两个研究中对临床和生物学特征与抑郁相关的结构性脑测量（前扣带回皮质[ACC]、眶额皮质、脑岛和伏隔核）进行了维度关联分析，并进行了荟萃分析。
抑郁严重程度与额极 ACC 厚度呈负相关（B=-0.55，p=0.03），忧郁症状与尾极 ACC 厚度呈负相关（B=-0.42，p=0.03）。非典型能量相关症状特征和免疫代谢指标与结构脑测量在各研究中没有一致的关联。
整体抑郁和忧郁症状严重程度与 ACC 厚度减少呈剂量反应关系。免疫代谢失调与结构性脑改变之间没有关联，这表明尽管两者都与抑郁有关，但可能涉及不同的机制。
